HIV Viral Load
Reviewed
Also called: nucleic acid testing, NAT, nucleic acid amplification test, NAAT, HIV PCR, RNA Test
This test measures the amount of HIV genetic material (RNA) in your blood. It is used to guide treatment decisions, monitor how well HIV medicines are working, and in certain cases to diagnose HIV infection. The test is a nucleic acid amplification test (NAAT), often called a PCR test. For monitoring, the goal is to achieve an undetectable viral load, which indicates the virus is controlled. For diagnosis, any detectable HIV RNA indicates an infection. Talk to your healthcare provider about the meaning of your results.
Specimen: Blood sample from a vein
Why this test may be ordered
- To guide decisions about HIV treatment after diagnosis
- To check how well HIV medicines are working
- To monitor changes in your HIV infection (getting worse, stable, or better)
- To diagnose HIV in newborns born to a person with HIV
- In certain cases, to diagnose HIV after a high-risk exposure or when early symptoms are present
Preparation and collection
You do not need any special preparations for this test. If you are being tested for HIV diagnosis, consider talking with a counselor before or after the test.
A blood sample is taken from a vein in your arm using a small needle. The procedure usually takes less than five minutes.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly. As with any lab test, there is a risk of false-positive or false-negative results; your healthcare provider will interpret the results in context. Emotional and privacy considerations include the need for counseling before and after diagnostic testing.
Understanding results
Results are interpreted based on whether the test is used for monitoring (after an HIV diagnosis) or for diagnosis. The amount of HIV RNA in your blood is measured; there is no standard reference range, so your healthcare provider will explain what your result means for you.
- Negative (No HIV detected) – Diagnostic: No HIV RNA was detected in your blood. Limitation: This result means you are probably not infected with HIV, but follow-up testing may be needed after a recent high-risk exposure. Next step: If you had a recent high-risk exposure, discuss with your provider whether follow-up testing is needed.
- Positive (HIV detected) – Diagnostic: HIV RNA was found in your blood. Limitation: Any detectable amount of HIV RNA indicates an HIV infection. Next step: Your provider will likely order additional tests, such as a CD4 count, to assess the stage of infection and start antiretroviral therapy.
- Undetectable (Negative) – Monitoring: Your HIV medicines are working well, your immune system is protected, and you are unlikely to spread HIV through sex. Limitation: An undetectable result does not mean you are cured; you must continue your medicines as prescribed. Next step: Continue your current antiretroviral therapy and have regular viral load tests every three to six months to monitor your infection.
- Low Viral Load – Monitoring: A low amount of HIV was detected in your blood. Limitation: This means your medicine is stopping the virus from growing and your infection is unlikely to get worse. Next step: Continue your current treatment and follow your provider's monitoring schedule.
- An undetectable viral load does not mean you are cured; you must continue taking your medicines as prescribed.
- A negative diagnostic result means you are probably not infected with HIV, but follow-up testing may be needed after a high-risk exposure.
- HIV viral load tests are expensive and are typically used after a positive screening test, unless you have a very high risk of infection.
- As with any lab test, there is a small risk of false-positive or false-negative results. Your healthcare provider will interpret your results in context.
- For diagnostic testing, counseling before and after the test is recommended to help you understand the results and your treatment options.
What to do next
Your healthcare provider will review your results and determine the next steps based on your specific situation. For monitoring, regular viral load tests every three to six months are typical. For a new diagnosis, additional tests such as a CD4 count may be ordered.
- What does my viral load result mean for my treatment plan?
- How often should I have this test?
- Can my viral load become undetectable even if I have HIV?
- What should I do if my viral load is high?
- Do I need any other tests to monitor my HIV infection?